STUDY:

JOURNAL: Diabetes Care. 2003;26:446-451

AUTHORS: Ronald A. Sherman, MD, MSC

ABSTRACT: Maggot therapy is more successful in debriding nonhealing ulcers than is continued conventional care.

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COMMENTARY: "Over the past few years, there has been a resurgence in the use of maggot therapy, even though its optimal role has not been clearly defined," write Ronald A. Sherman, MD, MSC, and colleagues from the Veterans Affairs Medical Center in Long Beach and the University of California, Irvine.

In the study, of 20 nonhealing ulcers in 18 patients, six wounds were treated with conventional therapy, six with maggot therapy, and eight with conventional therapy followed by maggot therapy.

Although conventional therapy failed to achieve any significant debridement during the first 14 days, maggot therapy allowed necrotic tissue to decrease by an average of 4.1 cm2 during the same time frame (P = .02). After five weeks of therapy, necrotic tissue still covered more than 33% of the surface of conventionally treated wounds, but maggot-treated wounds were completely debrided after four weeks of therapy (P = .001).

Growth of granulation tissue was faster and wound healing rates were also better with maggot therapy.

"Maggot therapy was more effective and efficient in debriding nonhealing foot and leg ulcers in male diabetic veterans than was continued conventional care," the authors write.